EP1663019A1 - Method and device for determining the angle between the femur and the tibia - Google Patents

Method and device for determining the angle between the femur and the tibia

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Publication number
EP1663019A1
EP1663019A1 EP03757835A EP03757835A EP1663019A1 EP 1663019 A1 EP1663019 A1 EP 1663019A1 EP 03757835 A EP03757835 A EP 03757835A EP 03757835 A EP03757835 A EP 03757835A EP 1663019 A1 EP1663019 A1 EP 1663019A1
Authority
EP
European Patent Office
Prior art keywords
tibia
femur
angle
unchanged
determining
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP03757835A
Other languages
German (de)
French (fr)
Other versions
EP1663019B1 (en
Inventor
François LEITNER
Yann Laugier
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
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Aesculap AG
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Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Publication of EP1663019A1 publication Critical patent/EP1663019A1/en
Application granted granted Critical
Publication of EP1663019B1 publication Critical patent/EP1663019B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A61B17/154—Guides therefor for preparing bone for knee prosthesis
    • A61B17/157—Cutting tibia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/102—Modelling of surgical devices, implants or prosthesis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/067—Measuring instruments not otherwise provided for for measuring angles

Definitions

  • the invention relates to a method for determining the angle between the femur and tibia during the implantation of a unicondylar knee prosthesis and a device for carrying out this method with a navigation system and a data processing device.
  • a unicondylar implant is placed on both the femur and the tibia, and these two implants may replace the natural articular surfaces of the femur and tibia on one side with the interposition of a sliding body.
  • both the tibia and the femur must be machined, the natural articular surfaces must be removed and contact surfaces for these unicondylar implants must be machined into the bone.
  • the location of these contact surfaces must be chosen according to the dimensions of the unicondylar implants used.
  • This object is achieved according to the invention in a method of the type described at the outset by determining the position of the unchanged articular surface on the tibia and / or the femur, and determining the position of an abutment surface for a unicondylar implant on the tibia and / or the femur and that one uses this position data and the geometric data of the unicondylar implant to calculate the angle between the femur and the tibia.
  • the described method can be carried out either on the tibia or on the femur or on both bones. It is essential that the contact surface for the unicondylar implant is determined and the total geometry of the knee is calculated based on the position data, i.e. the position in space and the orientation in space, and on the basis of the dimensions of the desired implant together with the position data of the unchanged articular surface.
  • the overall geometry then also gives the angle between the longitudinal axis of the tibia and the longitudinal axis of the femur. This angle can be influenced by changing the position data of the contact surface, so that the operator has the possibility of making angle corrections.
  • the position of the unchanged articular surface is determined by determining the position of at least one selected point of the unchanged articular surface. It is possible to determine the unchanged joint surface by only one point, for example the deepest point of the tibial joint surface, but it is also possible to record the position of several prominent points of this joint surface in order to determine the position of the unchanged joint surface.
  • the selected point or points of the unchanged articular surface can be determined by scanning.
  • the selected point or points of the unchanged articular surface are determined by determining the position of a navigated keyboard instrument with which the selected points are approached.
  • the position of the contact surface is defined before the preparation of the contact surface by means of an instrument arranged next to the tibia and / or femur.
  • the position of the instrument is preferably determined using a navigation System, so that one indirectly determines the position of the contact surface by the navigation system through the instrument.
  • a saw template is used as an instrument, which is then used immediately to guide a saw with which the contact surface is worked into the bone.
  • the angle between the femur and tibia can preferably be displayed on a screen, so that the surgeon can immediately see what influences a change in position of the contact surface and thus of the unicondylar implant has on the angle between the femur and tibia.
  • the surgeon can, for example, move the sawing jigs next to the bone to be machined until the angle between the femur and tibia assumes the desired size, and then this sawing jig can be fixed in the position reached relative to the bone, so that when the saw cut is made, the desired angle between the femur and tibia corresponding position of the contact surface is ensured.
  • the invention is also based on the object of designing a generic device in such a way that the angle between the femur and the tibia can be determined depending on the installation position of the unicondylar implant.
  • This object is achieved according to the invention in a device of the type described in the introduction in that an instrument for defining the position of a contact surface for a unicondylar implant on the tibia and / or on the femur is provided, the position of which relative to the position of the unchanged articular surface by the navigation system is determinable, and that the data Processing device calculated using this position data and the geometric data of the unicondylar implant, the angle between the femur and tibia.
  • this device can have a navigated keyboard instrument for determining the position of the unchanged articular surface.
  • the instrument is a saw template.
  • the device comprises a screen on which the angles between the femur and tibia calculated by the data processing device are displayed.
  • Figure 1 is a schematic view of a device for determining the angle between the femur and tibia with a navigation system, a data processing device and a navigated instrument for defining the contact surface of a unicondylar implant and
  • Figure 2 is a schematic view of the proximal end of the tibia with an unchanged articular surface and an articular surface replaced by a unicondylar implant.
  • the device 1 shown in FIG. 1 comprises a navigation system 2 of known type, with which the position of marking elements 3, that is to say the position and the orientation, can be determined. These marking elements 3 can be rigidly attached to instruments and other objects, so that the position of these instruments in space can also be determined.
  • Such navigation systems 2 work e.g. with the aid of infrared radiation, which is emitted by a plurality of transmitting and receiving devices 4 arranged at a distance from one another, reflected at different locations on the marking element 3 and then received again by the transmitting and receiving devices 4, the position data of the marking element 3 and thus the position data obtained therefrom Object to which the marking element 3 is attached are fed by the navigation system 2 to a data processing device 5, to which a screen 6 is assigned.
  • the device 1 described further comprises a saw jig 7, which is shown only very schematically in the drawing and which serves to guide an oscillating saw blade of a bone saw in one plane, and a keyboard instrument 8, with the tip of which selected points on bone structures can be approached , Both the saw gauge 7 and the keyboard instrument 8 are each connected to a marking element 3, so that the position of the saw gauge and keyboard instrument can be continuously detected by the navigation system 2.
  • the device 1 described is used to prepare a knee joint 9 for implantation of a unicondylar knee endoprosthesis.
  • one of the two articular surfaces 10 remains unchanged, while the other Steering surface removed and replaced on both the tibia 11 and the femur 12 by a unicondylar implant 13.
  • a longitudinal axis is first determined in a manner known per se for both the tibia 11 and the femur 12. This can be achieved, for example, by determining the center point of the knee joint and the center point of the hip joint or ankle joint for both bones; these points are used to determine the longitudinal axes.
  • both the femur and the tibia are provided with further marking elements, which are not shown in the drawing. These marking elements then also serve to determine the position of the femur and tibia using the navigation system.
  • Geometric data of the unchanged articular surface 10 are recorded with the aid of the keyboard instrument 8.
  • the keyboard instrument 8 either only approaches a selected point, possibly also a plurality of selected points, the location data of which are stored in the data processing device 5.
  • the saw jig 7 is arranged next to the bone to be machined and oriented in such a way that the saw plane defined by it defines a contact surface 14 for the implant 13.
  • This contact surface 14 will generally lie in the same plane in which the saw gauge 7 guides the saw blade of a saw, the plane defining the contact surface 14 then lies next to the saw gauge 7.
  • the position data for a specific position of the saw gauge and thus for a specific assumed one Contact surface 14 is also fed to the data processing device 5 and stored therein. Finally, the geometric data of the implant 13 used, for example the height of the implant, are also stored in this data processing device 5.
  • the latter calculates the angle between the longitudinal axes of the tibia and femur, this angle depends on the geometric data of the implant and on the position of the implant in the bone, both an axial displacement in the direction of the longitudinal axis of the bones and also a pivoting leads to a different positioning of the implant relative to the unchanged articular surface 10 and thus to a change in the angle ⁇ between the longitudinal axis 15 of the femur 12 and the longitudinal axis 16 of the tibia 11.
  • various such angles are shown that differ can result from the different positioning of the implant 13.
  • this also includes how the implant is arranged on the other bone, and therefore, with regard to the arrangement of the implant on the other bone, either a certain position is assumed, which is assumed, or a position on both bones becomes similar Accepted contact surface and varied by means of a saw gauge 7 until the desired angular orientation of the longitudinal axes 15 and 16 is reached.
  • the data processing device 5 transmits a schematic image of the knee joint to the screen 6 and represents on this the angle that is established between the longitudinal axis 15 and the longitudinal axis 16, optionally two views rotated by 90 ° can be displayed on the screen, so that the Bending in different directions is visible.
  • the representation on the screen can roughly correspond to the representation in FIG. 2, in which the unchanged articular surface is schematically next to one another and the position and orientation of the implant 13 according to the assumed position of the contact surface 14 become visible.
  • the longitudinal axes 15 and 16 and the angle ⁇ enclosed by them are shown.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Transplantation (AREA)
  • Dentistry (AREA)
  • Pathology (AREA)
  • Robotics (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)

Abstract

The invention relates to a method for determining the angle between the femur and the tibia during the implantation of a unicondylar knee prosthesis. The aim of the invention is to pre-determine the influence of the implantation position of the implant on the angle between the femur and the tibia. To this end, the position of the unchanged articulation surface on the tibia and/or on the femur is determined, the position of a bearing surface for a unicondylar implant on the tibia and/or on the femur is determined, and the angle between the femur and the tibia is calculated on the basis of said position data and the geometric data of the unicondylar implant.

Description

VERFAHREN UND VORRICHTUNG ZUR BESTIMMUNG DES WINKELS ZWISCHEN FEMU R UND TIBIA METHOD AND DEVICE FOR DETERMINING THE ANGLE BETWEEN FEMU R AND TIBIA

Die Erfindung betrifft ein Verfahren zur Bestimmung des Winkels zwischen Femur und Tibia bei der Implantation einer unikondylären Knieprothese sowie eine Vorrichtung zur Durchführung dieses Verfahrens mit einem Navigationssystem und einer Datenverarbeitungseinrichtung.The invention relates to a method for determining the angle between the femur and tibia during the implantation of a unicondylar knee prosthesis and a device for carrying out this method with a navigation system and a data processing device.

Neben dem Ersatz eines natürlichen Kniegelenks durch eine vollständige Knie- endoprothese ist es in einigen Fällen wünschenswert, das natürliche Kniegelenk nur einseitig zu ersetzen, also nur eine der beiden Kondylen des Kniegelenkes mittels einer Endoprothese zu ersetzen, die andere Gelenkfläche jedoch unverändert zu lassen. Beim Implantieren derartiger unikondylärer Endopro- thesen wird sowohl auf den Femur als auch auf die Tibia jeweils ein unikondy- läres Implantat aufgesetzt, und diese beiden Implantate ersetzen gegebenenfalls unter Zwischenlage eines Gleitkörpers die natürl ichen Gelenkflächen von Femur und Tibia auf einer Seite. Zur Implantation dieser unikondylären Implantate müssen sowohl Tibia als auch Femur bearbeitet werden, die natürlichen Gelenkflächen müssen entfernt werden und es müssen Anlageflächen für diese unikondylären Implantate in den Knochen eingearbeitet werden. Die Lage dieser Anlageflächen muß entsprechend den Abmessungen der verwendeten unikondylären Implantate gewählt werden.In addition to replacing a natural knee joint with a complete knee endoprosthesis, it is desirable in some cases to replace the natural knee joint only on one side, that is, to replace only one of the two condyles of the knee joint with an endoprosthesis, but to leave the other joint surface unchanged. When such unicondylar endoprostheses are implanted, a unicondylar implant is placed on both the femur and the tibia, and these two implants may replace the natural articular surfaces of the femur and tibia on one side with the interposition of a sliding body. To implant these unicondylar implants, both the tibia and the femur must be machined, the natural articular surfaces must be removed and contact surfaces for these unicondylar implants must be machined into the bone. The location of these contact surfaces must be chosen according to the dimensions of the unicondylar implants used.

Es hat sich nun herausgestellt, daß die Lage dieser Anlageflächen und damit die Lage der unikondylären Implantate den Winkel zwischen der Längsachse des Femurs und der Längsachse der Tibia sehr empfindlich beeinflußt. Dies gilt sowohl hinsichtlich einer Translation des Implantates parallel zur Längsrichtung des Femurs bzw. der Tibia als auch hinsichtlich einer Verschwenkung des Im- plantates gegenüber einer Ebene, die senkrecht auf der Längsachse von Tibia bzw. Femur steht.It has now been found that the position of these contact surfaces and thus the position of the unicondylar implants have a very sensitive influence on the angle between the longitudinal axis of the femur and the longitudinal axis of the tibia. This applies both with regard to a translation of the implant parallel to the longitudinal direction of the femur or the tibia and with regard to a pivoting of the plantates opposite a plane that is perpendicular to the longitudinal axis of the tibia or femur.

Es ist Aufgabe der Erfindung, ein Verfahren zur Bestimmung des Winkels zwischen Femur und Tibia in Abhängigkeit von der Implantatationslage der unikondylären Implantate anzugeben, um aufgrund dieser Bestimmung die gewünschte Lage der Anlagefläche zu finden.It is an object of the invention to provide a method for determining the angle between the femur and tibia depending on the implantation position of the unicondylar implants in order to find the desired position of the contact surface on the basis of this determination.

Diese Aufgabe wird bei einem Verfahren der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß man die Lage der unveränderten Gelenkfläche an der Tibia und/oder dem Femur bestimmt, daß man die Lage einer Anlagefläche für ein unikondyläres Implantat an der Tibia und/oder dem Femur bestimmt und daß man unter Verwendung dieser Lagedaten und der geometrischen Daten des unikondylären Implantats den Winkel zwischen Femur und Tibia errechnet.This object is achieved according to the invention in a method of the type described at the outset by determining the position of the unchanged articular surface on the tibia and / or the femur, and determining the position of an abutment surface for a unicondylar implant on the tibia and / or the femur and that one uses this position data and the geometric data of the unicondylar implant to calculate the angle between the femur and the tibia.

Das beschriebene Verfahren kann entweder an der Tibia oder am Femur durchgeführt werden oder auch an beiden Knochen. Wesentlich ist dabei, daß man die Anlagefläche für das unikondyläre Implantat bestimmt und aufgrund der Lagedaten, also der Position im Raum und der Orientierung im Raum, und aufgrund der Abmessungen des gewünschten Implantates zusammen mit den Lagedaten der unveränderten Gelenkfläche die Gesamtgeometrie des Knies berechnet. Aus dieser Gesamtgeometrie ergibt sich dann auch der Winkel zwischen der Längsachse der Tibia und der Längsachse des Femurs. Durch Veränderung der Lagedaten der Anlagefläche läßt sich dieser Winkel beeinflussen, so daß der Operateur die Möglichkeit hat, Winkelkorrekturen vorzunehmen. All diese Vorgänge werden durchgefühlt, bevor die Anlageflächen in den Knochen eingearbeitet werden, so daß der Operateur die Lage der Anlagefläche vor der Bearbeitung des Knochens beliebig verändern kann, um die optimale Anpassung zu erreichen. Dies gilt auch hinsichtlich der Auswahl von Implantaten mit geeigneten geometrischen Daten, durch Auswahl von Implantaten mit verschiedenen geometrischen Daten und entsprechend angepaßter Lage der Anlagefläche kann ebenfalls der Winkel zwischen Femur und Tibia beeinflußt werden.The described method can be carried out either on the tibia or on the femur or on both bones. It is essential that the contact surface for the unicondylar implant is determined and the total geometry of the knee is calculated based on the position data, i.e. the position in space and the orientation in space, and on the basis of the dimensions of the desired implant together with the position data of the unchanged articular surface. The overall geometry then also gives the angle between the longitudinal axis of the tibia and the longitudinal axis of the femur. This angle can be influenced by changing the position data of the contact surface, so that the operator has the possibility of making angle corrections. All of these processes are carried out before the contact surfaces are worked into the bone, so that the surgeon can change the position of the contact surface as desired before processing the bone in order to achieve the optimal adaptation. This also applies to the selection of implants with suitable geometric data; the angle between the femur and the tibia can also be influenced by selecting implants with different geometric data and a correspondingly adapted position of the contact surface.

Günstig ist es, wenn man die Lage der unveränderten Gelenkfläche durch Lagebestimmung mindestens eines ausgewählten Punktes der unveränderten Gelenkfläche bestimmt. Es ist möglich, die unveränderte Gelenkfläche durch nur einen Punkt zu bestimmen, beispielsweise den tiefsten Punkt der Tibia- gelenkfläche, es ist aber auch möglich, beispielsweise die Lage mehrerer markanter Punkte dieser Gelenkfläche zu erfassen, um die Lage der unveränderten Gelenkfläche zu bestimmen.It is advantageous if the position of the unchanged articular surface is determined by determining the position of at least one selected point of the unchanged articular surface. It is possible to determine the unchanged joint surface by only one point, for example the deepest point of the tibial joint surface, but it is also possible to record the position of several prominent points of this joint surface in order to determine the position of the unchanged joint surface.

Insbesondere kann man den oder die ausgewählten Punkte der unveränderten Gelenkfläche durch Abtasten bestimmen.In particular, the selected point or points of the unchanged articular surface can be determined by scanning.

Dabei ist es günstig, wenn man den oder die ausgewählten Punkte der unveränderten Gelenkfläche durch Bestimmung der Lage eines navigierten Tastinstruments bestimmt, mit dem die ausgewählten Punkte angefahren werden.It is advantageous if the selected point or points of the unchanged articular surface are determined by determining the position of a navigated keyboard instrument with which the selected points are approached.

Bei einer besonders bevorzugten Ausführungsform ist vorgesehen, daß man die Lage der Anlagefläche vor der Zubereitung der Anlagefläche mittels eines neben Tibia und/oder Femur angeordneten Instrumentes definiert. Vorzugsweise bestimmt man die Lage des Instrumentes mittels eines Navigations- Systems, so daß man indirekt durch das Instrument auch die Lage der Anlagefläche durch das Navigationssystem bestimmt.In a particularly preferred embodiment, it is provided that the position of the contact surface is defined before the preparation of the contact surface by means of an instrument arranged next to the tibia and / or femur. The position of the instrument is preferably determined using a navigation System, so that one indirectly determines the position of the contact surface by the navigation system through the instrument.

Es ist günstig, wenn man als Instrument eine Sägelehre verwendet, die dann gleich zur Führung einer Säge verwendet wird, mit der die Anlagefläche in den Knochen eingearbeitet wird.It is advantageous if a saw template is used as an instrument, which is then used immediately to guide a saw with which the contact surface is worked into the bone.

Den Winkel zwischen Femur und Tibia kann man vorzugsweise auf einem Bildschirm anzeigen, so daß der Operateur sofort sieht, welche Einflüsse eine Lageänderung der Anlagefläche und damit des unikondylären Implantates auf den Winkel zwischen Femur und Tibia hat. Der Operateur kann beispielsweise die Sägelehren neben dem zu bearbeitenden Knochen bewegen, bis der Winkel zwischen Femur und Tibia die gewünschte Größe einnimmt, und dann kann diese Sägelehre in der erreichten Position relativ zu dem Knochen fixiert werden, so daß bei Durchführung des Sägeschnittes dann die dem gewünschten Winkel zwischen Femur und Tibia entsprechende Lage der Anlagefläche sichergestellt ist.The angle between the femur and tibia can preferably be displayed on a screen, so that the surgeon can immediately see what influences a change in position of the contact surface and thus of the unicondylar implant has on the angle between the femur and tibia. The surgeon can, for example, move the sawing jigs next to the bone to be machined until the angle between the femur and tibia assumes the desired size, and then this sawing jig can be fixed in the position reached relative to the bone, so that when the saw cut is made, the desired angle between the femur and tibia corresponding position of the contact surface is ensured.

Der Erfindung liegt auch die Aufgabe zugrunde, eine gattungsgemäße Vorrichtung so auszugestalten, daß mit ihr der Winkel zwischen Femur und Tibia in Abhängigkeit von der Einbaulage des unikondylären Implantates bestimmbar ist.The invention is also based on the object of designing a generic device in such a way that the angle between the femur and the tibia can be determined depending on the installation position of the unicondylar implant.

Diese Aufgabe wird bei einer Vorrichtung der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß ein Instrument zur Definition der Lage einer Anlagefläche für ein unikondyläres Implantat an der Tibia und/oder am Femur vorgesehen ist, dessen Lage relativ zu der Lage der unveränderten Gelenkfläche durch das Navigationssystem bestimmbar ist, und daß die Daten- Verarbeitungseinrichtung unter Verwendung dieser Lagedaten und der geometrischen Daten des unikondylären Implantates den Winkel zwischen Femur und Tibia berechnet.This object is achieved according to the invention in a device of the type described in the introduction in that an instrument for defining the position of a contact surface for a unicondylar implant on the tibia and / or on the femur is provided, the position of which relative to the position of the unchanged articular surface by the navigation system is determinable, and that the data Processing device calculated using this position data and the geometric data of the unicondylar implant, the angle between the femur and tibia.

Insbesondere kann diese Vorrichtung ein navigiertes Tastinstrument zur Bestimmung der Lage der unveränderten Gelenkfläche aufweisen.In particular, this device can have a navigated keyboard instrument for determining the position of the unchanged articular surface.

Besonders vorteilhaft ist es, wenn das Instrument eine Sägelehre ist.It is particularly advantageous if the instrument is a saw template.

Weiterhin kann vorgesehen sein, daß die Vorrichtung einen Bildschirm umfaßt, auf dem die von der Datenverarbeitungseinrichtung berechneten Winkel zwischen Femur und Tibia angezeigt werden.Furthermore, it can be provided that the device comprises a screen on which the angles between the femur and tibia calculated by the data processing device are displayed.

Die nachfolgende Beschreibung bevorzugter Ausführungsformen der Erfindung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The following description of preferred embodiments of the invention serves in conjunction with the drawing for a more detailed explanation. Show it:

Figur 1: eine schematische Ansicht einer Vorrichtung zur Bestimmung des Winkels zwischen Femur und Tibia mit einem Navigationssystem, einer Datenverarbeitungseinrichtung und einem navigierten Instrument zur Definition der Anlagefläche eines unikondylären Implantates undFigure 1 is a schematic view of a device for determining the angle between the femur and tibia with a navigation system, a data processing device and a navigated instrument for defining the contact surface of a unicondylar implant and

Figur 2: eine schematische Ansicht des proximalen Tibiaendes mit einer unveränderten Gelenkfläche und einer durch ein unikondyläres Implantat ersetzten Gelenkfläche. Die in Figur 1 dargestellte Vorrichtung 1 umfaßt ein Navigationssystem 2 an sich bekannter Art, mit dem die Lage von Markierelementen 3, also die Position und die Orientierung, festgestellt werden kann. Diese Markierelemente 3 können an Instrumenten und anderen Gegenständen starr befestigt sein, so daß damit auch die Lage dieser Instrumente im Raum feststellbar ist.Figure 2 is a schematic view of the proximal end of the tibia with an unchanged articular surface and an articular surface replaced by a unicondylar implant. The device 1 shown in FIG. 1 comprises a navigation system 2 of known type, with which the position of marking elements 3, that is to say the position and the orientation, can be determined. These marking elements 3 can be rigidly attached to instruments and other objects, so that the position of these instruments in space can also be determined.

Derartige Navigationssysteme 2 arbeiten z.B. mit Hilfe von Infrarotstrahlung, die von mehreren, im Abstand zueinander angeordneten Sende- und Empfangseinrichtungen 4 ausgesandt, an unterschiedlichen Stellen des Markierelementes 3 reflektiert und dann von den Sende- und Empfangseinrichtungen 4 wieder empfangen wird, die daraus gewonnenen Lagedaten des Markierelementes 3 und damit des Gegenstandes, an dem das Markierelement 3 befestigt ist, werden von dem Navigationssystem 2 einer Datenverarbeitungseinrichtung 5 zugeführt, der ein Bildschirm 6 zugeordnet ist.Such navigation systems 2 work e.g. with the aid of infrared radiation, which is emitted by a plurality of transmitting and receiving devices 4 arranged at a distance from one another, reflected at different locations on the marking element 3 and then received again by the transmitting and receiving devices 4, the position data of the marking element 3 and thus the position data obtained therefrom Object to which the marking element 3 is attached are fed by the navigation system 2 to a data processing device 5, to which a screen 6 is assigned.

Die beschriebene Vorrichtung 1 umfaßt weiterhin eine Sägelehre 7, die in der Zeichnung nur sehr schematisch dargestellt ist und die dazu dient, ein oszillierendes Sägeblatt einer Knochensäge in einer Ebene zu führen, sowie ein Tastinstrument 8, mit dessen Spitze ausgewählte Punkte an Knochenstrukturen angefahren werden können. Sowohl die Sägelehre 7 als auch das Tastinstrument 8 sind jeweils mit einem Markierelement 3 verbunden, so daß die Lage von Sägelehre und Tastinstrument durch das Navigationssystem 2 kontinuierlich erfaßbar ist.The device 1 described further comprises a saw jig 7, which is shown only very schematically in the drawing and which serves to guide an oscillating saw blade of a bone saw in one plane, and a keyboard instrument 8, with the tip of which selected points on bone structures can be approached , Both the saw gauge 7 and the keyboard instrument 8 are each connected to a marking element 3, so that the position of the saw gauge and keyboard instrument can be continuously detected by the navigation system 2.

Die beschriebene Vorrichtung 1 dient der Vorbereitung eines Kniegelenks 9 zur Implantatation einer unikondylären Knieendoprothese. Bei dieser Operation bleibt eine der beiden Gelenkflächen 10 unverändert, während die andere Ge- lenkfläche entfernt und sowohl an der Tibia 11 als auch am Femur 12 durch ein unikondyläres Implantat 13 ersetzt wird.The device 1 described is used to prepare a knee joint 9 for implantation of a unicondylar knee endoprosthesis. In this operation, one of the two articular surfaces 10 remains unchanged, while the other Steering surface removed and replaced on both the tibia 11 and the femur 12 by a unicondylar implant 13.

Zur Vorbereitung der Operation wird zunächst in an sich bekannter Weise sowohl für die Tibia 11 als auch für den Femur 12 eine Längsachse bestimmt. Dies läßt sich beispielsweise dadurch erreichen, daß für beiden Knochen der Mittelpunkt des Kniegelenks und der Mittelpunkt des Hüftgelenks bzw. des Knöchelgelenks bestimmt wird, diese Punkte werden zur Festlegung der Längsachsen verwendet. Bei dieser Bestimmung werden sowohl Femur als auch Tibia mit weiteren Markierelementen versehen, die in der Zeichnung nicht dargestellt sind. Diese Markierelemente dienen dann auch dazu, die Lage von Femur und Tibia über das Navigationssystem zu bestimmen.To prepare for the operation, a longitudinal axis is first determined in a manner known per se for both the tibia 11 and the femur 12. This can be achieved, for example, by determining the center point of the knee joint and the center point of the hip joint or ankle joint for both bones; these points are used to determine the longitudinal axes. In this determination, both the femur and the tibia are provided with further marking elements, which are not shown in the drawing. These marking elements then also serve to determine the position of the femur and tibia using the navigation system.

Mit Hilfe des Tastinstruments 8 werden geometrische Daten der unveränderten Gelenkfläche 10 aufgenommen, dazu wird mit dem Tastinstrument 8 entweder nur ein ausgewählter Punkt angefahren, gegebenenfalls auch mehrere ausgewählte Punkte, deren Lagedaten in der Datenverarbeitungseinrichtung 5 gespeichert werden.Geometric data of the unchanged articular surface 10 are recorded with the aid of the keyboard instrument 8. For this purpose, the keyboard instrument 8 either only approaches a selected point, possibly also a plurality of selected points, the location data of which are stored in the data processing device 5.

Die Sägelehre 7 wird neben dem zu bearbeitenden Knochen angeordnet und so orientiert, daß die von ihr definierte Sägeebene eine Anlagefläche 14 für das Implantat 13 definiert. Diese Anlagefläche 14 wird in der Regel in derselben Ebene liegen, in der die Sägelehre 7 das Sägeblatt einer Säge führt, die die Anlagefläche 14 definierende Ebene liegt dann neben der Sägelehre 7. Die Lagedaten für eine bestimmte Position der Sägelehre und damit für eine bestimmte angenommene Anlagefläche 14 werden ebenfalls der Datenverarbeitungseinrichtung 5 zugeführt und in dieser gespeichert. Schließlich werden in dieser Datenverarbeitungseinrichtung 5 noch die geometrischen Daten des verwendeten Implantats 13 gespeichert, beispielsweise die Höhe des Implantates.The saw jig 7 is arranged next to the bone to be machined and oriented in such a way that the saw plane defined by it defines a contact surface 14 for the implant 13. This contact surface 14 will generally lie in the same plane in which the saw gauge 7 guides the saw blade of a saw, the plane defining the contact surface 14 then lies next to the saw gauge 7. The position data for a specific position of the saw gauge and thus for a specific assumed one Contact surface 14 is also fed to the data processing device 5 and stored therein. Finally, the geometric data of the implant 13 used, for example the height of the implant, are also stored in this data processing device 5.

Aus diesen in der Datenverarbeitungseinrichtung 5 gespeicherten Daten berechnet diese den Winkel zwischen den Längsachsen von Tibia und Femur, dieser Winkel hängt von den geometrischen Daten des Implantates und von der Lage des Implantates im Knochen ab, sowohl eine axiale Verschiebung in Richtung der Längsachse der Knochen als auch eine Verschwen kung führt zu einer unterschiedlichen Positionierung des Implantates relativ zur unveränderten Gelenkfläche 10 und damit zu einer Veränderung des Winkels Φ zwischen der Längsachse 15 des Femurs 12 und der Längsachse 16 der Tibia 11. In Figur 2 sind verschiedene derartige Winkel dargestellt, die sich aufgrund der unterschiedlichen Positionierung des Implantates 13 ergeben können. Dabei geht natürlich auch ein, wie das Implantat am jeweils anderen Knochen angeordnet ist, und daher wird hinsichtlich der Anordnung des Implantates am anderen Knochen entweder von einer bestimmten Position ausgegangen, die angenommen wird, oder es wird an beiden Knochen in ähnlicher Weise eine Lage der Anlagefläche angenommen und mittels einer Sägelehre 7 so variiert, bis die gewünschten Winkelorientierung der Längsachsen 15 und 16 erreicht wird.From this data stored in the data processing device 5, the latter calculates the angle between the longitudinal axes of the tibia and femur, this angle depends on the geometric data of the implant and on the position of the implant in the bone, both an axial displacement in the direction of the longitudinal axis of the bones and also a pivoting leads to a different positioning of the implant relative to the unchanged articular surface 10 and thus to a change in the angle Φ between the longitudinal axis 15 of the femur 12 and the longitudinal axis 16 of the tibia 11. In FIG. 2, various such angles are shown that differ can result from the different positioning of the implant 13. Of course, this also includes how the implant is arranged on the other bone, and therefore, with regard to the arrangement of the implant on the other bone, either a certain position is assumed, which is assumed, or a position on both bones becomes similar Accepted contact surface and varied by means of a saw gauge 7 until the desired angular orientation of the longitudinal axes 15 and 16 is reached.

Die Datenverarbeitungseinrichtung 5 übermittelt ein schematisches Bild des Kniegelenkes an den Bildschirm 6 und stellt auf diesem den Winkel dar, der sich zwischen der Längsachse 15 und der Längsachse 16 einstellt, gegebenenfalls können auf dem Bildschirm zwei um 90° verdrehte Ansichten dargestellt werden, so daß die Abwinkelung in unterschiedlichen Richtungen sichtbar wird. Die Darstellung auf dem Bildschirm kann etwa der Darstellung der Figur 2 entsprechen, in der schematisch nebeneinander die unveränderte Gelenkfläche sowie die Lage und Orientierung des Implantates 13 entsprechend der angenommenen Lage der Anlagefläche 14 sichtbar werden. Zusätzlich werden die Längsachsen 15 und 16 und der von ihnen eingeschlossene Winkel Φ dargestellt.The data processing device 5 transmits a schematic image of the knee joint to the screen 6 and represents on this the angle that is established between the longitudinal axis 15 and the longitudinal axis 16, optionally two views rotated by 90 ° can be displayed on the screen, so that the Bending in different directions is visible. The representation on the screen can roughly correspond to the representation in FIG. 2, in which the unchanged articular surface is schematically next to one another and the position and orientation of the implant 13 according to the assumed position of the contact surface 14 become visible. In addition, the longitudinal axes 15 and 16 and the angle Φ enclosed by them are shown.

Wenn der Operateur die Lage der Sägelehre 7 relativ zum Knochen verändert, bedeutet dies, daß auch die angenommene Lage der Anlagefläche 14 verschoben wird, und dies führt unmittelbar zu einer Veränderung des Winkels Φ zwischen den beiden Längsachsen 15 und 16. Der Operateur kann durch Lageveränderung der Anlagefläche 14 somit die gewünschte Orientierung dieser Längsachsen einstellen und somit die Anlagefläche 14 bestimmen, die für ein bestimmtes Implantat 13 in den Knochen eingearbeitet werden muß. If the operator changes the position of the saw jig 7 relative to the bone, this means that the assumed position of the contact surface 14 is also shifted, and this leads directly to a change in the angle Φ between the two longitudinal axes 15 and 16. The operator can change the position of the contact surface 14 thus set the desired orientation of these longitudinal axes and thus determine the contact surface 14 which must be worked into the bone for a specific implant 13.

Claims

PATENTANSPRÜCH EPATENT CLAIM E Verfahren zur Bestimmung des Winkels zwischen Femur und Tibia bei der Implantation einer unikondylären Knieprothese, dadurch gekennzeichnet, daß man die Lage der unveränderten Gelenkfläche an der Tibia und/oder dem Femur bestimmt, daß man die Lage einer Anlagefläche für ein unikondyläres Implantat an der Tibia und/oder dem Femur bestimmt und daß man unter Verwendung dieser Lagedaten und der geometrischen Daten des unikondylären Implantats den Winkel zwischen Femur und Tibia errechnet.Method for determining the angle between the femur and tibia during the implantation of a unicondylar knee prosthesis, characterized in that the position of the unchanged articular surface on the tibia and / or the femur is determined by determining the position of a contact surface for a unicondylar implant on the tibia and / or the femur and that one uses this position data and the geometric data of the unicondylar implant to calculate the angle between the femur and the tibia. 2. Verfahren nach Anspruch 1, dadurch gekennzeichnet, daß man die Lage der unveränderten Gelenkfläche durch Lagebestimmung mindestens eines ausgewählten Punktes der unveränderten Gelenkfläche bestimmt.2. The method according to claim 1, characterized in that the position of the unchanged articular surface is determined by determining the position of at least one selected point of the unchanged articular surface. Verfahren nach Anspruch 2, dadurch gekennzeichnet, daß man den oder die ausgewählten Punkte der unveränderten Gelenkfläche durch Abtasten bestimmt.Method according to claim 2, characterized in that the selected point or points of the unchanged articular surface are determined by scanning. 4. Verfahren nach einem der Ansprüche 2 oder 3, dadurch gekennzeichnet, daß man den oder die ausgewählten Punkte der unveränderten Gelenkfläche durch Bestimmung der Lage eines navigierten Tastinstrumentes bestimmt. 4. The method according to any one of claims 2 or 3, characterized in that the one or more selected points of the unchanged articular surface is determined by determining the position of a navigated keyboard. 5. Verfahren nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß man die Lage der Anlagefläche vor der Zubereitung der Anlagefläche mittels eines neben Tibia und/oder Femur angeordneten Instrumentes definiert.5. The method according to any one of the preceding claims, characterized in that one defines the position of the contact surface before the preparation of the contact surface by means of an instrument arranged next to the tibia and / or femur. Verfahren nach Anspruch 5, dadurch gekennzeichnet, daß man die Lage des Instrumentes mittels eines Navigationssystems bestimmt.Method according to claim 5, characterized in that the position of the instrument is determined by means of a navigation system. Verfahren nach Anspruch 5 oder 6, dadurch gekennzeichnet, daß man als Instrument eine Sägelehre verwendet.Method according to claim 5 or 6, characterized in that a saw template is used as the instrument. 8. Verfahren nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß man den Winkel zwischen Femur und Tibia auf einem Bildschirm anzeigt.8. The method according to any one of the preceding claims, characterized in that the angle between the femur and tibia is displayed on a screen. 9. Vorrichtung zur Bestimmung des Winkels zwischen Femur (12) und Tibia (11) bei der Implantation einer unikondylären Knieprothese mit einem Navigationssystem (2) und einer Datenverarbeitungseinrichtung (5), dadurch gekennzeichnet, daß ein Instrument (7) zur Definition der Lage einer Anlagefläche (14) für ein unikondyläres Implantat (13) an der Tibia (11) und/oder am Femur (12) vorgesehen ist, dessen Lage relativ zu der Lage der unveränderten Gelenkfläche (10) durch das Navigationssystem (2) bestimmbar ist, und daß die Datenverarbeitungseinrichtung (5) unter Verwendung dieser Lagedaten und der geometrischen Daten des unikondylären Implantates (13) den Winkel (Φ) zwischen Femur (12) und Tibia (11) berechnet.9. Device for determining the angle between the femur (12) and tibia (11) during the implantation of a unicondylar knee prosthesis with a navigation system (2) and a data processing device (5), characterized in that an instrument (7) for defining the position of a Contact surface (14) for a unicondylar implant (13) is provided on the tibia (11) and / or on the femur (12), the position of which can be determined by the navigation system (2) relative to the position of the unchanged articular surface (10), and that the data processing device (5) under Using this position data and the geometric data of the unicondylar implant (13) the angle (Φ) between the femur (12) and the tibia (11) is calculated. 10. Vorrichtung nach Anspruch 9, dadurch gekennzeichnet, daß sie ein navi- giertes Tastinstrument (8) zur Bestimmung der Lage der unveränderten Gelenkfläche (10) aufweist.10. The device according to claim 9, characterized in that it has a navigated keyboard (8) for determining the position of the unchanged articular surface (10). 11. Vorrichtung nach einem der Ansprüche 9 oder 10, dadurch gekennzeichnet, daß das Instru ment (7) eine Sägelehre ist.11. Device according to one of claims 9 or 10, characterized in that the instru ment (7) is a saw template. 12. Vorrichtung nach einem der Ansprüche 9 bis 11, dadurch gekennzeichnet, daß sie einen Bildschirm (6) umfaßt, auf dem die von der Datenverarbeitungseinrichtung (5) berechneten Winkel (Φ) zwischen Femur (12) und Tibia (11) angezeigt werden. 12. The device according to one of claims 9 to 11, characterized in that it comprises a screen (6) on which the angle (Φ) calculated by the data processing device (5) between the femur (12) and tibia (11) are displayed.
EP03757835A 2003-09-13 2003-09-13 Device for determining the angle between the femur and the tibia Expired - Lifetime EP1663019B1 (en)

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Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7983777B2 (en) * 2005-08-19 2011-07-19 Mark Melton System for biomedical implant creation and procurement
WO2011107147A1 (en) * 2010-03-03 2011-09-09 Brainlab Ag Method for enabling medical navigation with minimised invasiveness
EP2901946A1 (en) * 2014-02-03 2015-08-05 Arthrex Inc Pointing device and drilling tool

Family Cites Families (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5682886A (en) * 1995-12-26 1997-11-04 Musculographics Inc Computer-assisted surgical system
WO2000000093A1 (en) * 1998-06-29 2000-01-06 Plus Endoprothetik Ag Device and method for inserting a prosthetic knee
AU748703B2 (en) * 1999-03-17 2002-06-13 Ao Technology Ag Imaging and planning device for ligament graft placement
US7635390B1 (en) * 2000-01-14 2009-12-22 Marctec, Llc Joint replacement component having a modular articulating surface
US7104996B2 (en) * 2000-01-14 2006-09-12 Marctec. Llc Method of performing surgery
US6814735B1 (en) * 2000-07-28 2004-11-09 Biomet Merck Gmbh Device for aligning a guide template
EP1190676B1 (en) * 2000-09-26 2003-08-13 BrainLAB AG Device for determining the position of a cutting guide
FR2816200A1 (en) * 2000-11-06 2002-05-10 Praxim DETERMINING THE POSITION OF A KNEE PROSTHESIS
GB0101990D0 (en) * 2001-01-25 2001-03-14 Finsbury Dev Ltd Surgical system
US6514259B2 (en) * 2001-02-02 2003-02-04 Carnegie Mellon University Probe and associated system and method for facilitating planar osteotomy during arthoplasty
US7547307B2 (en) * 2001-02-27 2009-06-16 Smith & Nephew, Inc. Computer assisted knee arthroplasty instrumentation, systems, and processes
WO2002067784A2 (en) * 2001-02-27 2002-09-06 Smith & Nephew, Inc. Surgical navigation systems and processes for unicompartmental knee
WO2003045256A2 (en) * 2001-11-28 2003-06-05 Wright Medical Technology, Inc. Instrumentation for minimally invasive unicompartmental knee replacement
US20060106462A1 (en) * 2002-04-16 2006-05-18 Tsou Paul M Implant material for minimally invasive spinal interbody fusion surgery
WO2003090022A2 (en) * 2002-04-16 2003-10-30 Noble Philip C Computer-based training methods for surgical procedures
US7048741B2 (en) * 2002-05-10 2006-05-23 Swanson Todd V Method and apparatus for minimally invasive knee arthroplasty
WO2004041097A1 (en) * 2002-11-05 2004-05-21 Aesculap Ag & Co. Kg Method and device for determining the position of a knee-joint endoprosthesis
US7789885B2 (en) * 2003-01-15 2010-09-07 Biomet Manufacturing Corp. Instrumentation for knee resection
US7831295B2 (en) * 2003-06-05 2010-11-09 Aesculap Ag & Co. Kg Localization device cross check
DE502004004083D1 (en) * 2004-05-05 2007-07-26 Brainlab Ag Intramedullary nail tracking
WO2006034436A2 (en) * 2004-09-21 2006-03-30 Stout Medical Group, L.P. Expandable support device and method of use

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2005032382A1 *

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US20060195048A1 (en) 2006-08-31

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